Provider Demographics
NPI:1174843106
Name:DELANEY, NANCY B (PHD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:B
Last Name:DELANEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 MDG/SGOW
Mailing Address - Street 2:2050A SECOND STREET SE, KIRTLAND AFB
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87117-5522
Mailing Address - Country:US
Mailing Address - Phone:505-846-4511
Mailing Address - Fax:
Practice Address - Street 1:1 SOW MEDICAL GROUP
Practice Address - Street 2:113 LIELMANIS AVE.
Practice Address - City:HURLBURT FIELD
Practice Address - State:FL
Practice Address - Zip Code:32544
Practice Address - Country:US
Practice Address - Phone:850-884-2301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY129719103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist